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To explore the relationship and possible mechanism of reproductive function of bisphenol A (BPA) with polycystic ovary syndrome (PCOS).Serum specimens were collected from 43 PCOS patients and 37 healthy women.And the level of BPA was detected by enzyme-linked immunosorbent assay (ELISA).The serum level of BPA in PCOS were significantly higher than that in the control group.And the inter-group difference was significant (P ＜ 0.05).The patient level of BPA was positively related with obesity and basic luteinizing hormone (LH) (P ＜ 0.05).In the PCOS group,no significant correlation existed between hyperandrogenemia and non-hyperandrogenemia (P ＞ 0.05).Although no difference existed between insulin and non-insulin resistance,the level of BPA in insulin resistance group was lower than in non-insulin resistance group.A higher level of BPA may be associated with obesity and basic LH in PCOS.
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A total of 183 patients of ectopic pregnancy due to tubal factors were divided into the methotrexate (MTX),conservative surgery and salpingectomy groups.The dose of gonadotropin,counts of harvested oocytes and high-quality embryos and pregnancy rate were compared among three groups to analyze the differences of in vitro fertilization and embryo transfer (IVF-ET).And the above parameters showed no significant differences (P ＞0.05 ).The clinical pregnancy rate of the conservative group was higher than the other two groups.And the difference was statistically significant compared with salpingectomy ( P ＜ 0.05 ).It suggested that the treatments of ectopic pregnancy had some effects on the outcome of IVF-ET.The pregnancy rate was slightly higher in the conservative surgery group.
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One hundred and twenty-two infertile women with polycystic ovary syndrome (PCOS) and 112 infertile women without PCOS were interviewed with symptom checklist 90 ( SCL-90) and questionnaire of demographic and clinical characteristics to understand their psychological health status. Results demonstrated that scores of depression, interpersonal sensitivity, obsessive-compulsive and aggressive symptoms in infertile patients with PCOS were significantly higher than those in non-PCOS infertile ones (P < 0. 05 ). Acne had negative effect on their psychological health status (OR =3. 379, 95% CI = 1.096 ±10.419) . Scores of somzatization, interpersonal sensitivity, anxiety, obsessive-compulsive, aggressive and paranoid ideation symptoms were significantly higher in secondary infertile patients with PCOS than those in primary infertile ones (P<0. 05). Patients with PCOS had obviously psychological problems, especially in secondary infertile patients with PCOS ( P < 0. 05 ). Thus, it is suggested that psychological health status be evaluated in clinical diagnosis for infertile women so that they can be predicted and treated to improve its effectiveness.
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Objective To investigate factors that correlated to compliance of treatment in infertile patients with polycystic ovary syndrome (PCOS) to provide basis for clinical treatment, specialist consultation and health education. Methods Compliance was assessed by a questionnaire designed by reference to Morisky-Green test and therapeutic principles for PCOS. Interviews were performed in 128 infertile patients with PCOS in Renmin Hospital of Wuhan University, Wuhan, Hubei in China during March 2009 to September 2010. Data were analyzed with logistic regression. Results Logistic regression analysis revealed that a total of 41 (34.2% ) of 120 participants investigated showed good compliance. Factors that might significantly (P ＜ 0.05 ) correlate compliance of treatment included body mass index (BMI) of the patients ( OR = 2.426, 95% CI = 1.428 - 4.121 ), length of their marriage ( OR = 0.398, 95% CI =0.225 - 0.704) and their concerns for adverse drug reactions ( OR= 0.216, 95% CI = 0.067 - 0.694).Conclusions Patients with obesity, shorter length of marriage and concerns for adverse drug reactions show lower compliance. Publicity and intervention to those patients should be strengthened in clinics to improve their treatment compliance in patients with PCOS.
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BACKGROUND: Whether overweight and obesity have impact on the outcome of in vitro fertilization and embryo transfer (IVF-ET) treatment remains poorly understood.OBJECTIVE: To investigate the effect of women's body mass index (BMI) on the outcome of IVF-ET treatment. METHODS: A total of 184 cases were divided into 3 groups according to BMI: lankness group (BMI < 18.5 kg/m2), normal group (18.5kg/m2 ≤ BMI < 24 kg/m2), overweight and obesity group (BMI≥ 24 kg/m2). Treatments of ovulation induction and IVF-ET were regularly performed in the Reproductive Medical Center, Renmin Hospital of Wuhan University. The duration and dose of gonadotrophic hormone (GTH) treatment, estradiol level at the day of human chorionic gonadotropin (hCG) injection, and the differences of retrieved oocytes numbers, fertility rate, embryo quality, implantation rate, pregnancy rate and abortion rate were compared.RESULTS AND CONCLUSION: The dose of GTH used was in the overweight and obesity group was greater than that of the other groups (P< 0.05), and the dose was increased with BMI increasing. There was no significant difference in other aspects such as estradiol level, retrieved oocytes numbers, fertility rate, embryo quality, implantation rate, pregnancy rate and abortion rate at the day of hCG injection among the three groups (P> 0.05). All results demonstrated that overweight and obese patients require a higher hCG dose to achieve follicular maturation than normal weight patients. However, overweight and obesity does not affect negatively results of IVF-ET.
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BACKGROUND: Considerable debate exists which factors influence the outcomes of the vitrified frozen-thawed embryo transfer because lack of clinical applications.OBJECTIVE: To explore the factors influencing the outcomes of the vitrified frozen-thawed embryo transfer in assisted reproductive technology.METHODS: A retrospective statistical analysis was performed in Reproductive Medicine Center, Renmin Hospital of Wuhan University of 142 patients, 154 thawing cycles. The patients were grouped according to the age of patients, embryonic development, fertilization methods, endometrial preparation programs, the endometrial thickness, the process of transplantation and the survival cell ratio of embryo recovery, the implantation rate and clinical pregnancy rate were compared between various groups.RESULTS AND CONCLUSION: Among the groups of the different age, fertilization methods, endometrial preparation programs, endometrial thickness and the process of embryo transfer embryo implantation rate and clinical pregnancy rate were no significant difference (P > 0.05); between the two groups of the second day fertilized embryos (D2) and the third day (D3)fertilized embryos, the clinical pregnancy rate was not significant (P> 0.05), but the embryo implantation rate of D3 group was significantly higher than D2 group. The survival cell ratio of embryo recovery has a significant effect on implantation rate and clinical pregnancy rate (P < 0.05). Ln the frozen-thawed embryo transfer cycles, embryo quality plays a major role in pregnancy rate, and preparation for appropriate endometrial thickness can improve the clinical pregnancy rate.
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Seventy eight patients suspected of intrauterine adhesion (IUA) were scanned with two-dimensional (2D) and three-dimensional (3D) transvaginal uhrasonography, the results were analyzed with hysteroscopic findings as the gold standard. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of three-dimensional transvaginal ultrasonography in diagnosis of IUA were 97% (58/60), 18/18, 97% (76/78), 100% (58/58) and 90% (18/20). Three-dimensional transvaginal ultrasonography was more accurate in diagnosis of IUA than two-dimensional ultrasonography ( P < 0. 01 ),and the IUA classification and grading with three-dimensional transvaginal ultrasonography was better correlated with hysteroscopic findings.
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Objective To know prevalence of depression, its coping strategies and risk factors among infertile women with in vitro fertilization and embryo transfer (IVF-ET) or intracytoplasmic sperm injection. Methods Infertile women with IVF-ET were interviewed with center for epidemiologic studies short depression scale (CES-D10) and an abbreviated version of the COPE inventory (brief COPE), and their basal sex hormone values and estradiol ( E2 ) on the day of human chorionic gonadotropin (HCG) administration were monitored, as well as the number of oocytes yielded was counted. Results Prevalence of depression was 20.6% in infertile women, higher in those with more than eight years of marriage, infertility for more than six years, and receiving treatment for at least three years. Risk of depression among the women of infertility with monthly family income less than 3000 yuan was 14 times as those with more than 3000 yuan and risk of depression among them due to the factors of their husbands was 2/5 as those not due to men's. Depressive symptoms in the women increased with increasing of their basal follicle stimulating hormone (FSH) level, counted egg number and scores of denial items. Occurrence of their depressive symptoms decreased with higher basal E2 levels, and scores of substance use and humor. Conclusions Some infertile women with IVF-ET do have depression and preventive intervention should be aimed at related factors for depression to improve their psychological health.
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A cross-sectional study in 116 patients with polycystic ovary syndrome (PCOS) was carried out by using the short-form-36 health survey (SF-36), serf-rating anxiety scale ( SAS), and self-rating depression scale (SDS) from January 2008 to April 2008 in our reproduction center. In comparison with the healthy controls, the PCOS patients showed decreased quality of life (QOL) for all items of SF-36 (P<0.05) except for body pain or role-physical scales. The differences in SAS and SDS between the PCOS and the healthy controls were statistically significant (P<0.05). Our study results confirm the negative impacts of PCOS over the quality of life;subfertility, obesity, hirsutism, acne, complications, menstrual irregularity and educational levels might contribute to the reduced QOL.